Based On The Semi-structured Interview Method, The Factors Influencing The Surgical Decision Of Patients With Tophi Were Analyzed

Background:Gouty tophi can have an important impact on many aspects of the patients' life.Some patients went to surgery for improvement.However,no consensus has been reached in surgical indication among surgeons either domestic or abroad.Moreover,there are great misunderstanding on diagnosis and treatment between doctors and patients.It is important to understand patients' views on surgery.At present,study is limited in this area.We conducted a qualitative research on patients' surgical intention.Objectives:The aim of this qualitative study was to understand their opinions of tophi surgery and analysis the influencing factors on surgical decision,in order to help doctors understand patients' thoughts and respect their surgical decision,thus improving the quality of preoperational communication and establishing a patient-centered care model.Methods:Twenty patients with tophaceous gout(17 men)participated in telephone mediated semi-structured interviews that explored their surgical decision and reasons.Interviews were recorded and transcribed anonymously.The transcripts were analyzed and coded by Nvivo software tool to identify themes using thematic analysis frame.Results:There are 192 codes and two major themes arose from the interviews.They were factors that made patients refuse surgery and ones made them choose surgery.The sub-themes were personal factors,tophus factors,medication factors,surgical factors and others' opinions.Conclusions:The tophi surgical decision is influenced by many factors.Not only surgery and tophus itself can affect patient's decision,other factors such as medications,patient's personal characteristic and others' opinions may change the decision.However,this study can't determine how specific factors attributes patients' preference for tophi surgery.Based on this study,a discrete choice model can be created to assess how each factor influences patients' choice.